General election 2019: NHS needs commitment from the new government

Whichever political party or coalition wins on 12 December, a review of the structure of healthcare education and provision should be a priority

Whichever political party or coalition wins on 12 December, a  review of the structure of healthcare education and provision should be a priority

Stock image of a vote going in to a ballot box, with british and EU flags in the background

Thanks to Brexit and the general election, the UK is going through political upheaval, with all the political parties vying for our support by pulling metaphorical rabbits out of hats.

And what better way to win the public over than by promising reinvigoration and reinvestment in our national treasure, the NHS?

Political decisions affect NHS staffing

It is estimated that more than 10,000 EU nationals have left the NHS since the Brexit referendum, including almost 5,000 nurses. A freedom of information act submitted by the Guardian revealed that 3,250 EU staff left the NHS in 2019 alone.

In 2017 the government took the controversial decision to remove the underwriting of course fees and the nursing student bursary and replace it with the student loan system. This dramatically affected the number of applicants wanting to study nursing at university, with UCAS data identifying a cumulative decline of 25.2% since the abolition of the bursary.

Filling the gaps by creating new job roles

The NHS no longer resembles the plans presented by Aneurin Bevan in 1948 to the UK, although its core value of cradle to grave care still holds true. However, with the advent of medical science and pharmacological interventions, the adjunctive therapies offered today are colossal.  

To overcome the demands placed on the NHS, initiatives have been put in place. A review of primary healthcare provision by Health Education England (HEE) in 2012 identified a gap in skills and knowledge between GPs and practice nurses. Following the review, HEE introduced the physician associate role, a role first proposed in America in the 1960s to address the shortage of primary care physicians.

In 2015, HEE's Shape of Caring Review identified a gap between the skills of healthcare assistants and registered nurses. In reaction the government announced the creation of a new healthcare role in England – the nursing associate.

A hybrid healthcare system 

Constant firefighting to address gaps in knowledge and skill mix have created a hybrid healthcare system that adds the successful elements of the American, Canadian and Australasian healthcare systems to the NHS.

But as long as these changes are appended the NHS will remain flawed; as Aristotle said, the whole is greater than the sum of its parts.

What the NHS needs is a commitment from the newly elected government to review the structure of healthcare education and healthcare provision.

Mike Parker is associate professor in emergency nursing at the University of YorkMike Parker is associate professor in emergency nursing, University of York

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